A Proposal for Evaluating Student Medical Excuses

by Jeffrey Rosenthal and Dr. Louella Lobo, March 2020

Universities and colleges have to deal with the question of when students should be excused from required tests or assignments for medical reasons.

Ideally, we would simply trust students to be honest about their situation, but this is not always guaranteed. (For example, a few years ago a student told me he missed my midterm due to getting in a car accident and needing to wait for the police to arrive and fill out their report. I agreed this was a valid excused, and asked for a copy of the police report. He didn't reply, and instead immediately dropped the course, presumably because there was actually no accident or report after all.) And, it is unfair to the honest students if the dishonest ones are given unlimited undeserved accommodations.

So, instead, schools usually require students to get a form filled in by a medical doctor in order to get excused. This system has numerous disadvantages:

• Students might infect others while going to the doctor.
• Doctors have to spend precious time and energy dealing with such requests, at great cost to the public health system.
• The doctor may not be available until after the illness is resolved.
• Doctors often cannot accurately diagnose the problem (e.g. stomach cramps, migraines, etc) directly, and thus have to just assume the student is being honest.
• Each professor has to evaluate such claims themselves, without any particular expertise, and without the benefit of knowing the student's previous excuses in other classes.

We thus propose a different system. The school should set up a designated video call center to deal with student medical requests. The call center could be staffed by e.g. nurse practitioners or physician assistants, and confidentiality would be assured. Then, if a student is too ill or injured to complete a test or assignment, then they should initiate a video chat (e.g. Skype) with the center and explain their situation. The center can then make a judgement about whether or not a medical excuse is warranted. They could base this on their assessment of the student's medical condition, plus any additional evidence or documentation they wish to request, in addition to the student's past excuse requests.

Admittedly, this new center would cost the school. However, it would save a tremendous amount of money from the public medical system, so governments would have incentive to fund such centers. In addition, this new system would have numerous other advantages:

• Since the assessments are done by video chat, there is no infection risk.
• The center's staff could be well trained to assess student requests and ask appropriate questions and spot fraudulent claims.
• The center's staff could investigate as appropriate, while still maintaining complete confidentiality about the student's situation.
• The student requests would be handled centrally, thus ensuring both consistency of standards and the monitoring of student patterns over time to reveal serial fraud.
• Professors would not need to spend time assessing student medical requests (which they are not trained to do anyway).

Overall, we feel that this new system would be better for doctors, better for professors, and more fair and consistent for students. We hope that schools adopt this system today!

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